When NICE recommends a treatment 'as an option', the NHS must make sure it is available within 3 months of this guidance being published. This means that, if a patient has heavy menstrual bleeding and the doctor responsible for their care thinks that fluid-filled thermal balloon and microwave endometrial ablation techniques are the right treatment, they should be available for use, in line with NICE's recommendations.
All clinicians who care for women with HMB should review their current practice and policies to take account of the guidance set out in section 1.
Local guidelines, protocols or care pathways that refer to the care of women with HMB should incorporate the guidance.
To measure compliance locally with the guidance, the following criteria could be used. Further details on suggestions for audit are presented in appendix A.
A woman with HMB who has decided with the clinician responsible for treatment that surgical intervention is appropriate for the management of the condition is offered TBEA and MEA as treatment options, if they are not contraindicated.
The woman and the clinician responsible for treatment decide jointly on the choice of surgical treatment for HMB after an informed discussion.
Local clinical audits on the care of women with HMB could also include measurement of compliance with accepted clinical guidelines or protocols.